Sierra Leone

Test, Treat, and Track: Strengthening Malaria Response Capabilities in Sierra Leone

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The whole nation is at risk for this disease that is spread by mosquitoes and is the leading cause of death and illness.

“We need to reduce the malaria burden so that our people can have good health. So that when children go to school, they are able to perform better. So that when women get pregnant, they can deliver safely,” says Anitta. “That has been my goal: that I need to save mankind. So, I do whatever in my own capacity to help people.”

In her capacity as a registered nurse and case management team lead for the Sierra Leone National Malaria Control Program (NMCP), Anitta co-led an initiative to partner with private pharmacies on their response to patients with malaria.

This public-private partnership in Sierra Leone was a collaboration between USAID’s Human Resources for Health in 2030 (HRH2030) program; the U.S. President’s Malaria Initiative (PMI), the Global Fund to Fight AIDS, Tuberculosis and Malaria; the Pharmacy Consultancy of Sierra Leone; and the Sierra Leone National Malaria Control Program. HRH2030’s Capacity Building for Malaria activity works with PMI to strengthen the institutional and managerial capacities of National Malaria Control Programs in 10 countries.

In Sierra Leone, private pharmacies are the first line of defense against malaria but were historically not in line with the NMCP’s strategy. Interested in convenience and efficiency, patients would go to private pharmacies over free government clinics. Yet pharmacists would often give the sick person antimalarial pills as a precautionary measure without actually testing them for malaria. Unfortunately, this presumptive use of medication is not only wasteful and inefficient, but can also have negative side effects on patients, including ulcers and kidney damage.

Aware of these patterns, and rather than encouraging people to choose public clinics over private pharmacies, the NMCP partnered with pharmacies to strengthen their malaria case management capabilities. Anitta and her colleague Brenda Stafford, a trained pharmacist and Procurement and Supply Management officer, led the initiative, going pharmacy-to-pharmacy to train staff on the NMCP’s “Three T” approach: Test, Treat, and Track.

Public health problems, private sector partners

To address the first T, private pharmacies were given free malaria rapid diagnostic tests.

According to 2016 data, only half of children under-five with fever received appropriate malaria testing. For the second T, the pharmacists were trained on malaria prevention, treating patients with uncomplicated malaria, and referring patients with severe malaria to health facilities.

As for the last T, tracking malaria test results is key in forecasting the spread of disease. Anitta and Brenda provided pharmacies with two forms that track results: a registry form to track patient information and a summary form which aggregates that into monthly data reports – allowing the NMCP to identify disease patterns and forecast supply to better plan for use of malaria test results and drugs.

Thanks to NMCP staff like Anitta and Brenda, 160 pharmacy staff in six cities are now trained on the Three T approach and a total of 90 pharmacies have begun using free malaria test kits and implementing the Three T approach.

“This partnership allows for more cooperation and collaboration between healthcare providers and other stakeholders, and overall more success in combating the disease,” Anitta said.